Prediction of Placenta Accreta Using Hyperglycosylated Human Chorionic Gonadotropin

Objectives: Hyperglycosylated human chorionic gonadotropin (hCG) is a variant of hCG. In addition, it has a different oligosaccharide structure compared to the regular hCG and promotes the invasion and differentiation of peripheral cytotrophoblast. This study aimed to measure hyperglycosylated hCG as a predictor in the diagnosis of placenta accreta. Materials and Methods: In general, 90 pregnant women were involved in this case-control study among which, 30 ladies (control group) were pregnant within the gestational age of ≥36 weeks with at least one previous caesarean section and a normal sited placenta in transabdominal ultrasound (TAU). The other 60 pregnant women (case group) were within a gestational age of ≥36 weeks at least, one previous caesarean section and placenta previa with or without signs of placenta accreta in TAU. Hyperglycosylated hCG and total hCG were measured in each group and the results of the surgery were followed up. Results: Hyperglycosylated hCG showed higher serum levels in patients with placenta accreta compared to those with placenta previa and control women. Hyperglycosylated hCG with an optimal cut point of (3) IU/L predicted placenta accreta in pregnant women with 90% specificity, 76.7% sensitivity, and 81.1% accuracy. Conclusions: The high specificity of the above approach makes it a good diagnostic tool (as a single test) for confirming placenta accreta in clinical settings. When this test is added to our established workup, its high positive predictive value makes it a suitable method within the algorithm of accreta confirmation when there is a high suspicion or insufficient evidence to the diagnosis of placenta accreta.

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Indicators for mode of delivery in pregnant women with uteruses scarred by prior caesarean section: a retrospective study of 679 pregnant women

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2604-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Zhifen Hua ◽

Fadwa El Oualja

Keyword(s):

Retrospective Study ◽

Caesarean Section ◽

Pregnant Women ◽

Vaginal Delivery ◽

Gestational Age ◽

Placenta Previa ◽

Mode Of Delivery ◽

Fetal Membrane ◽

Delivery Mode ◽

Maternal Preference

Abstract Background The delivery mode for pregnant women with uteruses scarred by prior caesarean section (CS) is a controversial issue, even though the CS rate has risen in the past 20 years. We performed this retrospective study to identify the factors associated with preference for CS or vaginal birth after CS (VBAC). Methods Pregnant women (n = 679) with scarred uteruses from Moulay Ali Cherif Provincial Hospital, Rashidiya, Morocco, were enrolled. Gestational age, comorbidity, fetal position, gravidity and parity, abnormal amniotic fluid, macrosomia, placenta previa or abruptio, abnormal fetal presentation, premature rupture of fetal membrane with labor failure, poor progression in delivery, and fetal outcomes were recorded. Results Out of 679 pregnant women ≥28 gestational weeks, 351 (51.69%) had a preference for CS. Pregnant women showed preference for CS if they were older (95% CI 1.010–1.097), had higher gestational age (95% CI 1.024–1.286), and a shorter period had passed since the last CS (95% CI 0.842–0.992). Prior gravidity (95% CI 0.638–1.166), parity (95% CI 0.453–1.235), vaginal delivery history (95% CI 0.717–1.818), and birth weight (95% CI 1.000–1.001) did not influence CS preference. In comparison with fetal preference, maternal preference was the prior indicator for CS. Correlation analysis showed that pregnant women with longer intervals since the last CS and history of gravidity, parity, and vaginal delivery showed good progress in the first and second stages of vaginal delivery. Conclusions We concluded that maternal and gestational age and interval since the last CS promoted CS preference among pregnant women with scarred uteruses.

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ANALISIS FAKTOR RISIKO YANG BERHUBUNGAN DENGAN KEJADIAN PLASENTA PREVIA

JURNAL KEDOKTERAN ◽

10.36679/kedokteran.v6i2.338 ◽

2021 ◽

Vol 6 (2) ◽

pp. 100

Author(s):

Nurul Huda Mursalim ◽

Saharuddin Saharuddin ◽

Azizah Nurdin ◽

Jelita Inayah Sari

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Pregnant Women ◽

Placenta Previa ◽

Case Control ◽

Control Group ◽

Chi Square ◽

Purposive Sampling ◽

Chi Square Test ◽

History Of

Tujuan penelitian ini adalah untuk mengetahui hubungan variabel dependen yaitu umur, paritas, riwayat sectio sesarea, riwayat gemelli dengan variabel independen yaitu plasenta previa di RSUD Batara Guru dan RS Hikmah Sejahtera Kabupaten Luwu Tahun 2018-2019. Pada studi ini memanfaatkan metode analitik observasional dengan pendekatan case control. Sampel ditentukan melalui perbandingan kelompok kasus sebanyak 50 sampel dengan kelompok kontrol 50 sampel. Teknik sampling menggunakan purposive sampling. Untuk mengetahui hubungan faktor risiko memanfaatkan uji chi square. Hasil terbanyak didapatkan 78 ibu hamil risiko rendah, 76 ibu hamil dengan multipara, ibu hamil dengan tidak ada riwayat sectio sesarea didapatkan 76 ibu hamil dan ibu yang tidak memiliki riwayat gemelli ada 97 ibu hamil. Hasil penelitian menujukkan dari uji chi square antara umur dengan plasenta previa didapatkan (P= 0.008 < 0,05) untuk hubungan paritas dengan plasenta previa didapatkan (P= 0,815 > 0,05) hubungan riwayat sectio sesarea didapatkan sebesar (P= 0.035 < 0,05) dan untuk hubungan riwayat gemelli sebesar (P= 1,000 > 0,05). Kesimpulan dari penelitian ini adalah tidak terdapat hubungan faktor risiko paritas, riwayat gemelli pada kejadian plasenta previa dan didapatkan hubungan faktor risiko antara umur, riwayat sectio sesarea dengan kejadian plasenta previa di RSUD Batara Guru dan RS Hikmah Sejahtera Kabupaten Luwu Tahun 2018-2019. Kata kunci: Umur, paritas, riwayat sectio sesarea, riwayat gemelli, plasenta previa ABSTRACTThe major objective of this study was to investigate the risk factors that affect the occurrences of placenta previa, such as ages, parity, caesarean section history, and gemelli history of pregnant women. This study was conducted at Batara Guru Hospital and Hikmah Sejahtera Hospital of Luwu Regency in 2018 to 2019. The methodological approach taken in this study was observational analytic by using a case control approach. The samples used in this research consisted of 50 samples for the case group and 50 samples for the control group. The sampling technique used was a purposive sampling. A chi square test was performed in this experiment in order to understand the risk factors. From this research, it was apparent that 78 pregnant women were with the low risk of getting placenta previa, 76 pregnant women were with multiparous, 76 pregnant women were with no history of cesarean section, and 79 pregnant women were without a gemelli history. Based on the chi square test, the results of this study indicated that various relationships were obtained such as the relationship between ages and placenta previa occurrences with (P = 0.008 <0.05), the correlation among parity and placenta previa occurrences with (P = 0.815> 0.05), the correlation among caesarean section history and placenta previa occurrences with (P = 0.035 <0,05), and the correlation among gemelli history and placenta previa occurrences with (P = 1,000> 0.05). This research concludes that there was no relationship between parity and gemelli history factors and the occurrences of placenta previa. In contrast, it was evident that there were close relationships between the ages and caesarean section history factors and the occurrences of placenta previa at Batara Guru Hospital and Hikmah Sejahtera Hospital of Luwu Regency in 2018 to 2019.Keywords: ages, parity, caesarean sectio history, gemelli history, placenta previa

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EVALUATION OF HUMAN CHORIONIC GONADOTROPIN IN VAGINAL WASHINGS FOR THE EARLY DIAGNOSIS OF PREMATURE RUPTURE OF FOETAL MEMBRANES: A CLINICAL STUDY

10.36106/9233765 ◽

2021 ◽

pp. 49-50

Author(s):

Komal Yadav ◽

Sadhna Mathur ◽

Surabhi Tomar ◽

Faizah Yousuf

Keyword(s):

Pregnant Women ◽

Chorionic Gonadotropin ◽

Human Chorionic Gonadotropin ◽

Demographic Data ◽

Control Group ◽

Premature Rupture ◽

Beta Hcg ◽

Group 2 ◽

Group B ◽

Group 1

Aim: This study is aimed to evaluate and validate the qualitative human chorionic gonadotropin β subunit (β-hCG) test of the vaginal uid washings of pregnant women with premature rupture of fetal membranes (PROM). Materials & Methodology: A total of 60 pregnant women between 26- and 36-weeks' gestation had participated in this study. The patients with leaking from the vagina were designated Group A, the patients with no leaking from the vagina were Group B. After administering 5 cc of normal saline to posterior fornix by sterile injector, a total of 5 cc washing uid was collected. human chorionic gonadotropin were examined on the same day on collected uid and both groups were compared statistically. Result: In the current study 53.4% patients in group 1 and 60.0% patients from control group were between 19-25 years of age group. Majority of patients were unbooked in both groups. 46.6% patients in PROM group and 56.6% patients in control group presents before 34 weeks of gestation. There is no statistical signicance between two groups in terms of demographic data. Beta -HCG values in vaginal uid of Group 1 was signicantly higher than values in Group 2 with cut off value of Beta -HCG as 50mIU/dL. 83.4% patients from Group 1 (PROM Group) shows Beta -HCG value more than 50Miu/dL.

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Hyperglycosylated chorionic gonadotropin – prognostic criteria development of complications of pregnancy

HEALTH OF WOMAN ◽

10.15574/hw.2017.121.82 ◽

2017 ◽

pp. 82-85

Author(s):

N.V. Pehnyo ◽

Keyword(s):

Pregnant Women ◽

Chorionic Gonadotropin ◽

Human Chorionic Gonadotropin ◽

Prognostic Significance ◽

Neonatal Morbidity ◽

First Trimester ◽

Trophoblast Invasion ◽

Placental Dysfunction ◽

Hyperglycosylated Human Chorionic Gonadotropin ◽

First Trimester Of Pregnancy

The objective: to assess the prognostic significance of the level of serum hyperglycosylated human chorionic gonadotropin (gHCG) reative to the development of pregnancy complications that lead to impaired fetal conditions. Materials and methods. 382 pregnant women were examined who were on the register, were hospitalized in case of complications of pregnancy and gave birth to KCMH №2 (Kiev). All pregnant women were evaluated serum gCGG in the period of 8-10 weeks gestation, evaluated the course and result of pregnancy. Results. Reduction in the level of gHCG is a marker of insufficient trophoblast invasion, which is likely to lead to the formation of placental dysfunction and the development of a variety of obstetric pathology complicating the course of pregnancy and a risk factor for antenatal loss and neonatal morbidity. The conclusion. Determination of the level of hyperglycosylated human chorionic gonadotropin in the first trimester of pregnancy will make it possible to identify pregnant women at risk for the formation of placental dysfunction and propose a set of monitoring activities aimed at early detection of violations of pregnancy and their timely removal. This helps prevent the formation of severe pathological conditions during pregnancy in both the mother and the fetus, which corresponds to the current trends in the development of medical care, namely: prediction, prevention and individual approach. Key words: hyperglycosylated chorionic gonadotrophin, complications of pregnancy, disturbed fetal condition.

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PLACENTA ACCRETA - A MANAGEMENT ENIGMA

10.36106/gjra/2900382 ◽

2019 ◽

pp. 1-3

Author(s):

Bhakti Bawankule ◽

Sushree Patra ◽

Sushil Kumar

Keyword(s):

Caesarean Section ◽

Iliac Artery ◽

Internal Iliac Artery ◽

Placenta Accreta ◽

Placenta Previa ◽

Previous Caesarean Section ◽

Artery Ligation ◽

Internal Iliac Artery Ligation ◽

Internal Iliac ◽

The Mean

AIMS AND OBJECTIVES: 1. To analyse maternal and foetal outcomes 2. To analyse types of interventions. MATERIALS AND METHODS: It is a retrospective study conducted over a period of 3years (Jan2017-August 2019), in Department of Obstetrics & Gynaecology at our hospital. Out of 9000deliveries conducted in 3years, 12patients were found to have accreta during caesarean section. Cases were analysed for interventions and maternal and foetal outcome. RESULTS: The mean age of patient included was 25.7yrs ranging from 21-35 yrs. 7patients were gravida 2, 3were gravida 3 and 2 were gravida 4. The mean gestational age was 34.4 weeks ranging from 27.1 to 37.5 weeks. History of D&C was present in 1case, H/O previous LSCS was present in all cases, H/O placenta previa in current pregnancy was present in7/12 cases. H/O previous caesarean section with placenta previa in this pregnancy was present in 7cases. Hysterectomy alone was done in 9patients. Hysterectomy with Internal Iliac Artery Ligation was done in 3patients. Average blood loss was around 1700 ml & blood transfusion was required in all patients. Total 6 patients required ICU care, with 1maternal death and 2 IUFD. CONCLUSION: Antenatal diagnosis of placenta accreta is a challenge. With increasing frequency of previous caesarean section and placenta previa the prevalence of placenta accreta is increasing. With advent of newer interventions and availability of interventional radiologists death due to massive haemorrhage is reducing. Obstetric hysterectomy and Internal Iliac artery Ligation still remains the mainstay of treatment. However, morbidly adherent placenta is a threat to both patient and obstetrician.

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KARAKTERISTIK PERDARAHAN ANTEPARTUM DAN PERDARAHAN POSTPARTUM

Jurnal e-Biomedik ◽

10.35790/ebm.1.1.2013.4608 ◽

2013 ◽

Vol 1 (1) ◽

Author(s):

T. H. M. Londok ◽

Rudy A. Lengkong ◽

Eddy Suparman

Keyword(s):

Caesarean Section ◽

Antenatal Care ◽

Pregnant Women ◽

Gestational Age ◽

Postpartum Hemorrhage ◽

Medical Records ◽

Placenta Previa ◽

Post Partum ◽

Mother’S Age ◽

In Pregnancy

Abstract: The most important cause of hemorrhage in pregnancy and parturition are antepartum hemorrhage and postpartum hemorrhage. The purpose of this research is to investigate the characteristics of antepartum hemorrhage and postpartum hemorrhage at Prof DR. R.D Kandou General Hospital Manado in 2011. This research used a retrospective descriptive through medical records at BLU RSUP Prof dr R.D Kandou Manado in January 2011 to December 2011. From 4155 parturition case in 2011, there were 60 cases (1,44%) of antepartum hemorrhage and 36 case (0,86%) of postpartum hemorrhage. The highest sociodemographic distribution found : in mother’s age between 35-39 years old, in highschool students, and housewives . The highest medico obstetric distribution found: 17 cases (28,3%) of first parity and 17 cases (28,3%) second parity of antepartum hemorrhage and 18 cases (50%) of first parity in postpartum hemorrhage, in gestational age between 37-42 week, 32 cases (53,3%) of antepartum hemorrhage and 30 cases (83,3%) of postpartum hemorrhage. The perabdominal parturition (caesarean section), there were 55 cases (91,7%) of antepartum hemorrhage and 22 case (61,1%) of pervaginam in postpartum hemorrhage. The causes of antepartum hemorrhage were placenta previa in 59 cases (98,3%) and retained placenta in 10 cases (27,8%). The most number of antenatal care check ups were ≥4x check ups on antepartum hemorrhage cases and <4x on postpartum hemorrhage cases. These high incidents needs to be noted by all parties. Pregnant women who are in risk for antepartum hemorrhage and postpartum hemorrhage need to be routinety and checked up and carefulle for their pregnancy. Keywords: Antepartum Hemorrhage, Postpartum Hemorrhage, Patient Characteristic. Abstrak: Penyebab perdarahan pada kehamilan dan persalinan yang penting adalah perdarahan antepartum dan perdarahan postpartum. Tujuan penelitian ini untuk mengetahui karakteristik perdarahan antepartum dan perdarahan postpartum di BLU RSUP Prof DR. R.D Kandou Manado tahun 2011. Penelitian ini menggunakan metode retrospektif deskriptif melalui rekam medik di BLU RSUP Prof dr R.D Kandou Manado tahun 2011. Dari 4155 total persalinan seluruhnya pada tahun 2011, terdapat 60 kasus (1,44%) perdarahan antepartum dan 36 kasus (0,86%) perdarahan postpartum. Distribusi sosiodemografi tertinggi : umur ibu 35-39 tahun, pendidikan terakhir tamat SMA, pekerjaan ibu rumah tangga. Distribusi mediko obstetri tertinggi: 17 kasus (28,3%) paritas pertama dan 17 kasus (28,3%) paritas kedua pada perdarahan antepartum dan 18 kasus (50%) paritas pertama pada perdarahan postpartum, usia kehamilan biasanya 37-42 minggu yaitu 32 kasus (53,3%) perdarahan antepartum dan 30 kasus (83,3%) perdarahan postpartum. Tindakan persalinan perabdominal (seksio sesarea) 55 kasus (91,7%) perdarahan antepartum dan 22 kasus (61,1%) pervaginam perdarahan post partum. Penyebab perdarahan antepartum terbanyak adalah plasenta previa dan perdarahan postpartum disebabkan oleh sisa plasenta. Kebanyakan jumlah pemeriksaan antenatal care ≥4x pemeriksaan pada perdarahan antepartum dan <4x pemriksaan pada perdarahan postpartum. Tingginya angka kejadian ini perlu mendapat perhatian dari semua pihak. Ibu-ibu hamil yang memiliki faktor resiko untuk terjadinya perdarahan antepartum dan perdarahan post partum agar selalu waspada dan selalu memeriksakan kehamilannya kepada tenaga ahli secara berkala dan teratur. Kata kunci: Perdarahan Antepartum, Perdarahan Postpartum, Karakteristik Penderita.

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Levels of Thyroid Hormones and Human Chorionic Gonadotropin in Normotensive Pregnant Women

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1443 ◽

2016 ◽

Vol 8 (4) ◽

pp. 324-326

Author(s):

Akhilesh Kumar Singh ◽

Bechan Kumar Gautam

Keyword(s):

Thyroid Hormones ◽

Pregnant Women ◽

Chorionic Gonadotropin ◽

Human Chorionic Gonadotropin ◽

Thyroid Stimulating Hormone ◽

Control Group ◽

Hormonal Changes ◽

Total Triiodothyronine ◽

Total Thyroxine ◽

Chemiluminescent Immunoassay

ABSTRACT During pregnancy the hormonal changes take place, resulting in changes in thyroid functions. The present study was conducted to determine thyroid hormones and human chorionic gonadotropin (hCG) in normotensive pregnancy. Fifty normotensive pregnant subjects were included in the study. Age-matched 50 nonpregnant subjects, not having any disease were taken as control. Total triiodothyronine (total T3), total thyroxine (total T4), thyroid stimulating hormone (TSH), and hCG were estimated by using enzyme amplified chemiluminescent immunoassay. The level of thyroid hormones was found significantly increased in normotensive pregnant subjects as compared to that of control group. We therefore conclude that investigations should be done routinely in pregnancy. How to cite this article Singh AK, Agrawal P, Gautam BK, Garg R. Levels of Thyroid Hormones and Human Chorionic Gonadotropin in Normotensive Pregnant Women. J South Asian Feder Obst Gynae 2016;8(4):324-326.

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Evaluation of prenatal changes in fetal cardiac morphology and function in maternal diabetes mellitus using a novel fetal speckle-tracking analysis: a prospective cohort study

Cardiovascular Ultrasound ◽

10.1186/s12947-021-00256-z ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Dong Wang ◽

Caixia Liu ◽

Xinyu Liu ◽

Ying Zhang ◽

Yu Wang

Keyword(s):

Diabetes Mellitus ◽

Cohort Study ◽

Pregnant Women ◽

Gestational Age ◽

Speckle Tracking ◽

Control Group ◽

Second Trimester ◽

Cardiac Morphology ◽

Sphericity Index ◽

And Function

Abstract Background Due to metabolic changes in the second trimester and the increasing number of pregnant women with obesity and advanced maternal age, the incidence of gestational diabetes mellitus (GDM) remains high. This study aimed to evaluate the effects of GDM on fetal cardiac morphology and function, and to determine whether these changes increase with increasing estimated fetal weight (EFW). Methods Fifty-eight women with GDM (GDM group) and 58 women with a healthy pregnancy (control group) were included in this prospective observational cohort study. Each group included subgroups of 31 pregnant women with a gestational age between 24+0 weeks and 27+6 weeks as well as 27 pregnant women with a gestational age between 28+0 weeks and 40+0 weeks. For all fetuses, a cine of 2–3 s in the four-chamber view was obtained, and online speckle-tracking analysis was performed using the GE Automatic Fetal Heart Assessment Tool (fetal HQ; General Electric Healthcare Ultrasound, Zipf, Austria) to measure the global sphericity index (GSI), global longitudinal strain (GLS), fractional area change (FAC), 24-segment sphericity index (SI), and 24-segment end-diastolic diameter of the left ventricle (LV) and right ventricle (RV). Data were analyzed using the independent t-test and Wilcoxon rank-sum test, as applicable. Results The GDM group (mean HbA1c value was 5.3 ± 0.57 mmol/L) showed a lower GSI value than the control group (1.21 vs. 1.27, P = 0.000), which indicated a rounder shape of the heart. In addition, fetuses in the GDM group demonstrated significant impairment in cardiac function compared to those in the control group (LV-GLS: -18.26% vs. -22.70%, RV-GLS: -18.52% vs. -22.74%, LV-FAC: 35.30% vs. 42.36%, RV-FAC: 30.89% vs. 36.80%; P = 0.000 for all). Subgroup analyses according to gestational age (24+0–27+6 weeks and 28+0–40+0 weeks) showed that the statistical differences were retained between the GDM and control groups in each subgroup. Conclusions Fetuses of women with GDM present with signs of biventricular systolic dysfunction according to deformation analysis using fetal HQ. Additionally, the heart had a rounder shape in the GDM group than in the control group. This study showed that fetal HQ can be used to assess fetal cardiac morphology and function easily and quickly, and the effects of GDM on fetal cardiac morphology and function appeared from the second trimester. Thus, whether earlier and stricter clinical intervention was necessary remained to be further studied. Furthermore, future studies will need to supplement the effects of blood glucose levels on GLS, FAC, GSI, and 24-segment SI. Additionally, the long-term follow-up after birth should also be improved to observe the influence of changes in the indicators on the prognosis.

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